CAJ | 학술논문

目的：探讨马来酸桂哌齐特（ CM）对急性脑梗死（ ACI）患者炎症因子及神经功能缺损程度的影响。方法选择急性脑梗死患者80例，采用随机数字表法将其分为两组，每组40例。对照组给予常规治疗（脱水、抗凝、护脑、高压氧及对症治疗），观察组在对照组治疗基础上给予马来酸桂哌齐特治疗，疗程14 d。监测两组治疗前后白细胞介素－6（IL－6）、肿瘤坏死因子－α（TNF－α）、可溶性细胞间黏附分子－1（sICAM－1）、基质金属蛋白酶－9（MMP－9）水平、梗塞体积及美国国立卫生研究院卒中量表（NIHSS）评分，并评定临床疗效。结果治疗14 d后，观察组基本痊愈19例，显著进步14例，进步6例，无效1例；对照组依次为10、12、10、8例，观察组疗效优于对照组（ P＜0．05）。治疗前两组患者的IL－6、TNF－α、sICAM－1、MMP－9水平、梗塞体积及NIHSS评分比较差异无统计学意义（P均＞0．05），具有可比性。治疗14 d后两组患者的上述指标均较治疗前显著改善（P均＜0．01），观察组较对照组改善更显著（P均＜0．01）。观察组不良反应发生率为15％，与对照组的10％比较差异无统计学意义（χ2＝0．4571，P＞0．05）。结论 CM治疗急性脑梗死安全有效，能缩小梗死面积，改善预后，降低炎症因子（IL－6、TNF－α、sICAM－1、MMP－9）水平可能为其作用机制之一。
목적：탐토마래산계고제특（ CM）대급성뇌경사（ ACI）환자염증인자급신경공능결손정도적영향。방법선택급성뇌경사환자80례，채용수궤수자표법장기분위량조，매조40례。대조조급여상규치료（탈수、항응、호뇌、고압양급대증치료），관찰조재대조조치료기출상급여마래산계고제특치료，료정14 d。감측량조치료전후백세포개소－6（IL－6）、종류배사인자－α（TNF－α）、가용성세포간점부분자－1（sICAM－1）、기질금속단백매－9（MMP－9）수평、경새체적급미국국립위생연구원졸중량표（NIHSS）평분，병평정림상료효。결과치료14 d후，관찰조기본전유19례，현저진보14례，진보6례，무효1례；대조조의차위10、12、10、8례，관찰조료효우우대조조（ P＜0．05）。치료전량조환자적IL－6、TNF－α、sICAM－1、MMP－9수평、경새체적급NIHSS평분비교차이무통계학의의（P균＞0．05），구유가비성。치료14 d후량조환자적상술지표균교치료전현저개선（P균＜0．01），관찰조교대조조개선경현저（P균＜0．01）。관찰조불량반응발생솔위15％，여대조조적10％비교차이무통계학의의（χ2＝0．4571，P＞0．05）。결론 CM치료급성뇌경사안전유효，능축소경사면적，개선예후，강저염증인자（IL－6、TNF－α、sICAM－1、MMP－9）수평가능위기작용궤제지일。
Objective To study the effects of cinepazide maleate on inflammatory factors and neural func-tional defects in patients with acute cerebral infarction( ACI) .Methods Eighty patients with ACI were randomly di-vided into two groups, with 40 cases in each group.The control group(n=40) was given routine treatment(dehydra-tion, anticoagulation, protecting brain, hyperbaric oxygen and symptomatic treatment) and the observation group( n=40) was given cinepazide maleate based on the same treatment in the control group.Both of the two groups were treated for 14 days.The levels of IL-6, TNF-α, sICAM-1, MMP-9, infarct volume and NIHSS score were detected in each group before and after treatment and their clinical efficacy were evaluated.Results After 14 days of the treat-ment, the efficacy was excellent in 19 cases, good in 14 cases, improved in 6 cases in the observation group, and in-valid in 1 case;the efficacy counterparts in the control group were 10, 12, 10 and 8 respectively.The effect of the observation group was better than that of the control group( P<0.05) .There were no significant differences between the two groups in the levels of IL-6, TNF-α, sICAM-1, MMP-9, infarct volume and national institute health stroke scale(NIHSS) score before the treatment(P>0.05).After 14 days of the treatment, the above indicators in the two groups were significantly improved than those before the treatment(P<0.01), however the indicators were improved more obviously in the observation group(P<0.01);There was no significant difference in the incidence of adverse reactions between the observation group(15%) and the control group(10%)(χ2 =0.4571, P>0.05).Conclusion Cinepazide maleate is safe and effective in the treatment of acute cerebral infarction.It can reduce infarction area, improve prognosis and reduce the levels of inflammatory factors (IL-6, TNF-α, sICAM-1, MMP-9), which may be one of the mechanisms of action.